Magnetic resonance imaging in two patients with radiation myelopathy

Findings of magnetic resonance imaging (MRI) in 2 patients with radiation myelopathy are reported. One patient developed Brown-Séquard syndrome 7 months after radiotherapy for carcinoma of the nasopharynx. MRI done 8 months after clinical manifestations revealed long segmental enlargement of the cervical cord, low signal intensity on T1-weighted images and high signal intensity on T2-weighted images of the cervical cord. The other patient presented with bulbar palsy and Brown-Séquard syndrome 4 years after radiotherapy for carcinoma of the nasopharynx. MRI done 1 month after clinical manifestations showed a high signal intensity area on T2-weighted images of the medulla oblongata and the higher cervical cord. These findings corresponded well with the neurological level. In a proper clinical setting, findings of MRI may be helpful in the diagnosis of radiation myelopathy.